Excision vs ablation
|Excision doesn’t damage the tissues, therefore a biopsy of the excised tissues can be obtained, confirming the diagnosis. When it is done by an experienced endometriosis specialist, excision surgery has a low rate of recurrence, reducing the symptoms and improving fertility, thus having a positive impact on the patient’s life.
The effectiveness of excising implants has been noted in clinical trials and through direct patients’ observation . Both methods noted that excision of endometriosis resulted in fewer symptoms years after surgery in comparison with patients who underwent ablation surgery, and the symptoms returned within months.
Cases of advanced disease experienced have a greater response to laparoscopic excision and a significant improvement in the symptoms of endometriosis. Ablation may vaporize the surface of a lesion and still leave active disease below, and it is particularly true for deeply invasive nodules of the uterosacral ligaments. With ablation, active disease can remain in the pelvis and continue to cause pain. This method can cause more scarring and tissue damage, deep implants cannot be reached, and there are no tissues for pathology to confirm the diagnosis.
With ablation there is a possibility of accidentally damaging the underlying tissue, such as the bowel, bladder or ureter; therefore implants that lie over vital organs, such as the bowel and large blood vessels are left untreated, resulting in higher recurrence more than 80% and further surgeries.